Otoko no ko refers to people assigned male at birth but identify themselves female. They may undergo hormone replacement therapy and gender confirmation surgery to align physical appearance with their gender identity. Mtf are often connected to the Josou community and enjoy sharing their femininity through attire and makeup. Some individuals may identify as trap on a part-time or full-time basis, depending on their comfort level. In recent years, otoko no ko have more visible and accepted in society, resulting in enhanced awareness and understanding.